| NPI | 1609340280 |
|---|---|
| Former Name | KATELYN BAGLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP029293) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: PA RN664823) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2024-02-15 |